融合结节作为晚期III/IV期口咽鳞状细胞癌远处转移的预测指标
Matted nodes as a predictor of distant metastasis in advanced-stage III/IV oropharyngeal squamous cell carcinoma.
作者信息
Spector Matthew E, Chinn Steven B, Bellile Emily, Gallagher K Kelly, Ibrahim Mohannad, Vainshtein Jeffrey, Chanowski Eric J, Walline Heather M, Moyer Jeffrey S, Prince Mark E, Wolf Gregory T, Bradford Carol R, McHugh Jonathan B, Carey Thomas, Worden Francis P, Eisbruch Avraham, Chepeha Douglas B
机构信息
Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
Department of Biostatistics, University of Michigan Health System, Ann Arbor, Michigan.
出版信息
Head Neck. 2016 Feb;38(2):184-90. doi: 10.1002/hed.23882. Epub 2015 Jun 30.
BACKGROUND
We recently described the imaging characteristics of multiple confluent regional metastases (matted nodes) and found that this characteristic was associated with distant metastasis in patients with oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was to determine if matted nodes are a predictive marker for distant metastasis.
METHODS
Radiologic lymph node characteristics on 205 patients with untreated stage III/IV with oropharyngeal SCC of whom 192 had known human papillomavirus (HPV) status underwent weekly carboplatin and paclitaxel with concomitant intensity-modulated radiation therapy (IMRT) between 2003 and 2010 with a minimum of 2-year of follow-up.
RESULTS
The 3-year disease-specific survival (DSS) for patients with matted nodes was 58% versus 97% with nonmatted nodes (p = .0001). The prevalence of matted nodes in the population was 20%. The positive predictive value of matted nodes for distant metastasis was 66%, and the negative predictive value was 99%.
CONCLUSION
Matted nodes are a predictive marker for distant disease and can be used for planning new clinical interventions.
背景
我们最近描述了多发融合性区域转移（融合结节）的影像学特征，并发现该特征与口咽鳞状细胞癌（SCC）患者的远处转移相关。本研究的目的是确定融合结节是否为远处转移的预测标志物。
方法
对205例未经治疗的III/IV期口咽SCC患者的放射学淋巴结特征进行研究，其中192例已知人乳头瘤病毒（HPV）状态，在2003年至2010年间接受每周一次的卡铂和紫杉醇联合调强放疗（IMRT），并至少随访2年。
结果
有融合结节患者的3年疾病特异性生存率（DSS）为58%，无融合结节患者为97%（p = .0001）。人群中融合结节的患病率为20%。融合结节对远处转移的阳性预测值为66%，阴性预测值为99%。
结论
融合结节是远处疾病的预测标志物，可用于规划新的临床干预措施。
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